| NPI | 1215199013 |
|---|---|
| Former Name | MELISSA S WAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 55059) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116020632) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2015-09-01 |